Healthcare proposal concerns Riverside county

Riverside County officials say they are becoming increasingly worried about having enough money to provide medical care to residents through the county hospital and 10 public health clinics as they brace for the 2014 rollout of federal health care reform.

The county's $625 million healthcare system normally pays for itself through federal and state grants, and fees for services. But this fiscal year the safety net for the region's poor and uninsured has been running a $30 million deficit.

Officials said in a report to the Board of Supervisors they have found a way to plug the hole this year, but worry about being able to do so again in the new budget year.

It doesn't help that proposals circulating in Sacramento are spreading anxiety that Riverside County may not receive adequate funding to cover increased responsibilities as a result of the January debut of the federal Affordable Care Act.

"That's certainly the elephant in the room," said Doug Bagley, chief executive officer for the Riverside County Regional Medical Center, which is in Moreno Valley.

Ed Corser, the county's chief financial officer, said a way must be found to place the hospital and clinics on solid footing.

"You can't move into a brand-new program with lots of unknowns when you are unstable in the first place," Corser said. "That can't happen. Whether or not we can come in and solve the problem, I don't know."

The question has implications not only for health care for Riverside County's low-income residents, but also for the county government's general fund budget. Supervisors generally count on the health care system being able to take care of itself, and if it can't they might have to siphon money away from other programs to help pay its bills.

That's not terribly attractive at a time when the county is facing a $20 million shortfall in fiscal year 2013-14, which begins July 1. At the Feb. 26 board meeting, Corser outlined $40 million in new expenses next year that would be offset by a $20 million bump in revenue.

For the first time in several years, the county has a balanced budget. Corser said the county will stay within that $630 million overall budget for local services, including law enforcement.

"We will not touch reserves," he said.

But challenges lie ahead. And one of the biggest is health care.

The sweeping change in health care that will debut in 2014 is expected to inject millions of federal funding into Riverside County to serve people who lack access to care now. But, in view of that pending infusion of money, Gov. Jerry Brown has proposed taking back some state health dollars distributed to California's 58 counties, Bagley said.

"That's not good," he said.

On the other hand, Bagley said the proposal may open the door ---- for the first time in many years ---- to talk about changing a formula for distributing those health dollars that Riverside County long has maintained is unfair.

Developed by the Legislature, the formula divides health funding based on how many people live below the poverty line, multiplied by an amount that varies greatly county to county.